One session treatment for dental phobia in an underserved population

服务欠缺人群的牙科恐惧症的一次疗程治疗

基本信息

批准号：
10348505
负责人：
THOMAS H. OLLENDICK
金额：
$ 32.68万
依托单位：
UNIVERSITY OF TEXAS RIO GRANDE VALLEY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-06 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10348505
关键词：
Address Adherence Adolescence Adolescent Adult Affect Age Anxiety Anxiety Disorders Appearance Area Automobile Driving Award Basic Science Child Childhood Clinic Clinical Clinical Research Clinical Trials Communities Controlled Study Country Data Data Collection Dental Dental Anxiety Dental Care Dental Clinics Dental Hygienists Dental Offices Dentists Development Diet Disease Dissemination and Implementation Documentation Eating Ensure Etiology Evidence based treatment Family Feasibility Studies Fright Future Goals Good Clinical Practice Grant Health Professional Healthcare Hispanic Hispanic Populations Individual Interdisciplinary Study Interruption Intervention Intervention Studies Knowledge Label Laboratories Latino Learning Literature Low income Measures Mediating Mediator of activation protein Medical National Institute of Dental and Craniofacial Research Odontogenesis Oral Oral health Pain Participant Patient Recruitments Phase Phobias Prevalence Procedures Quality of life Randomized Relaxation Therapy Sampling Shame Specific Phobia Testing Tooth structure Treatment outcome Underserved Population United States Work Youth acceptability and feasibility active control anxious base behavioral clinical trial childhood anxiety clinical research site community setting comparative efficacy effective therapy efficacious treatment efficacy evaluation experience high risk implementation efforts participant retention patient response psychoeducation recruit retention rate social standard of care success theories treatment arm treatment effect trial comparing

Address Adherence Adolescence Adolescent Adult Affect Age Anxiety Anxiety Disorders Appearance Area Automobile Driving Award Basic Science Child Childhood Clinic Clinical Clinical Research Clinical Trials Communities Controlled Study Country Data Data Collection Dental Dental Anxiety Dental Care Dental Clinics Dental Hygienists Dental Offices Dentists Development Diet Disease Dissemination and Implementation Documentation Eating Ensure Etiology Evidence based treatment Family Feasibility Studies Fright Future Goals Good Clinical Practice Grant Health Professional Healthcare Hispanic Hispanic Populations Individual Interdisciplinary Study Interruption Intervention Intervention Studies Knowledge Label Laboratories Latino Learning Literature Low income Measures Mediating Mediator of activation protein Medical National Institute of Dental and Craniofacial Research Odontogenesis Oral Oral health Pain Participant Patient Recruitments Phase Phobias Prevalence Procedures Quality of life Randomized Relaxation Therapy Sampling Shame Specific Phobia Testing Tooth structure Treatment outcome Underserved Population United States Work Youth acceptability and feasibility active control anxious base behavioral clinical trial childhood anxiety clinical research site community setting comparative efficacy effective therapy efficacious treatment efficacy evaluation experience high risk implementation efforts participant retention patient response psychoeducation recruit retention rate social standard of care success theories treatment arm treatment effect trial comparing

展开

项目摘要

PROJECT SUMMARY/ABSTRACT Dental phobia is associated with avoidance of proper dental care, poor dental health, and decrements in social and oral quality of life. Although dental phobia may persist for many years, the disorder usually first manifests during childhood or adolescence. Hispanic youth may be at particularly high risk of developing dental phobia because Hispanic/Latino families are less likely to take a preventative stance toward dental health. This means that Hispanic youths’ first encounters with a dentist are more likely to be for treatment that is associated with pain, discomfort, or shame – the types of learning experiences related to the development of dental phobia. Although our knowledge about the etiology of dental phobia is well developed, we know considerably less about how to treat dental phobia in youth. Recently, a one-session exposure therapy treatment (OST) for specific phobias has proven successful in addressing a variety of phobias in children and adolescents. However, youth with dental/medical phobias have not been included in the trials assessing OST because of the need to include dental health professionals in the treatment. Therefore, the primary goal of this application is to prepare for and conduct a Stage III trial comparing OST for dental phobia in children and adolescents to an active control treatment in a predominantly Hispanic population and to examine inhibitory learning as the mechanism responsible for changes in anxiety and fear. The aims of the UG3 phase are to do the preparatory work needed for the trial, including the development of all study documentation and finalizing the clinical sites. Additional plans during the UG3 phase include the assessment of the acceptability and feasibility of the study procedures and a trial examining whether youth treated with OST show evidence of changes in inhibitory learning. The primary aim of the UH3 stage is to examine the efficacy of OST in a Stage III social/behavioral clinical trial in which OST is delivered by dental hygienists. This trial would randomize dental clinics to one of the two treatment arms (OST vs. Control) so that patient response and the hypothesized mechanism of treatment can be assessed. Factors related to future dissemination and implementation efforts will also be examined. It is hypothesized that OST can provide an efficacious treatment option that can be delivered by hygienists in the dental office. That is, that the treatment can decrease both anxiety and phobic avoidance in youth. Moreover, although exposure therapy has a high level of empirical support in youth and a good deal of laboratory work has been conducted to develop the theory to explains its effects, the main hypothesized mechanism of action – inhibitory learning – has not been studied as a mediator within the context of a clinical trial; therefore, this work could advance our understanding of the mechanism driving one of the most promising treatments for individuals with anxiety disorders.

项目摘要/摘要牙齿恐惧症与避免适当的牙齿护理，牙齿健康不良以及社会下降有关和口头生活质量。尽管牙齿恐惧症可能会持续多年，但该疾病通常首先表现出来在童年或青少年期间。西班牙裔青年可能患牙齿恐惧症的风险特别高因为西班牙裔/拉丁裔家庭不太可能对牙齿健康采取预防措施。这意味着西班牙裔青年与牙医的第一次遇到更有可能与疼痛，不适或震惊 - 与牙齿恐惧症发展有关的学习经历的类型。尽管我们对牙齿恐惧症病因的了解良好，但我们仔细了解如何治疗青年牙齿恐惧症。最近，针对特定的一项一次性暴露疗法（OST）事实证明，恐惧症已成功解决儿童和青少年的各种恐惧症。但是，青年由于需要包括治疗中的牙科卫生专业人员。因此，此应用程序的主要目标是准备并进行III期试验，将儿童和青少年牙齿恐惧症的OST与主动控制在主要是西班牙裔人群中的治疗，并检查抑制性学习作为机制负责焦虑和恐惧的变化。 UG3阶段的目的是完成所需的准备工作对于该试验，包括制定所有研究文档和最终确定临床部位。额外的 UG3阶段的计划包括评估研究程序的可接受性和可行性以及一项检查青年是否对OST进行治疗的试验显示抑制性学习变化的证据。这 UH3阶段的主要目的是检查OST在III期社会/行为临床试验中的有效性这是由牙科卫生员提供的。该试验将将牙科诊所随机与两者之一治疗臂（OST与控制），以便患者反应和假设的治疗机制可以被评估。还将检查与未来传播和实施工作有关的因素。这是假设OST可以提供有效的治疗方案牙科办公室。也就是说，这种治疗可以减轻青年人的焦虑和恐惧症。而且，尽管暴露疗法在青年和大量实验室工作中具有很高的经验支持已经进行了开发理论来解释其效应，这是主要假设的作用机理 - 在临床试验的背景下，抑制性学习 - 尚未被研究为调解人；因此，这个工作可以促进我们对驱动最有前途的治疗方法之一的理解患有焦虑症的人。